Lung cancer, a formidable adversary within the realm of oncology, has long been a source of concern and curiosity. Lung cancer kills more people than breast, colon, and prostate cancer combined, thus we at RRMCH bring to you this blog that aims to shed light on the intricacies of this disease, exploring its causes, risk factors, types, symptoms, and the crucial role of early detection and prevention strategies.
Understanding Lung Cancer
Lung cancer occurs when abnormal cells within the lungs undergo uncontrolled growth, leading to the formation of tumours. Primarily categorised into two types—small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC)—this disease is notorious for its aggressive nature and potential to metastasize.
Risk Factors
Several factors contribute to the development of lung cancer, with tobacco smoke being the leading culprit. Individuals who smoke, or are exposed to secondhand smoke, face a significantly higher risk. Other risk factors include exposure to radon gas, asbestos, certain chemicals, a family history of lung cancer, and pre-existing lung diseases.
Types of Lung Cancer
These two main types, NSCLC and SCLC, have distinct characteristics, behaviours, and treatment approaches.
Non-Small Cell Lung Cancer (NSCLC)
- Prevalence: NSCLC accounts for approximately 85% of all lung cancer cases, making it the most common type.
- Subtypes: NSCLC is further categorised into three main subtypes based on the type of cells where cancer originates:
- Adenocarcinoma: This subtype often begins in the cells that produce mucus in the bronchi and is more common in non-smokers and women.
- Squamous Cell Carcinoma: Arising in the squamous cells lining the bronchial tubes, this subtype is often linked to smoking.
- Large Cell Carcinoma: This is a less common subtype and tends to grow and spread quickly as it can spread in any part of the organ.
Small Cell Lung Cancer (SCLC)
- Characteristics: Small-cell lung cancer is characterised by small, round cells that grow rapidly and have the potential to metastasize early in the disease.
- Aggressiveness: SCLC is known for its aggressive nature, and it is often diagnosed at an advanced stage.
- Association with Smoking: Almost all cases of SCLC are associated with a history of smoking, either current or past.
- Treatment Approach: SCLC is typically treated with a combination of chemotherapy and radiation therapy. Surgical removal is less common due to the tendency of SCLC to spread quickly.
The choice of treatment depends on factors such as the type and stage of lung cancer, the patient’s overall health, and whether the cancer has spread to other parts of the body. It’s important to note that within NSCLC, the specific subtype (adenocarcinoma, squamous cell carcinoma, or large cell carcinoma) can influence treatment decisions. Additionally, advancements in molecular and genetic testing have led to the identification of specific mutations and biomarkers that can further guide targeted therapies for certain types of lung cancer, contributing to more personalised and effective treatment strategies.
Symptoms
Lung cancer symptoms can be subtle in the early stages, making it challenging to detect. However, as the disease progressed the symptoms became apparent and more commonly noticeable. Common signs include persistent cough, chest pain, shortness of breath, hoarseness, weight loss, and recurring respiratory infections. When the symptoms prompt and you recognize them more commonly seek medical attention as it might help with early diagnosis.
Diagnosis
To develop an effective treatment the doctor will require an accurate diagnosis. Diagnostic methods include imaging tests (X-rays, CT scans), biopsy, and bronchoscopy. Early detection significantly improves the chances of successful treatment and increases survival rates.
Treatment Options
The treatment of lung cancer is complex and varies based on several factors, including the type and stage of the cancer, the patient’s overall health, and individual preferences. Here, we’ll delve into the primary treatment modalities for lung cancer:
Surgery
During surgery, the tumour and surrounding tissue are removed. The kind and stage of the cancer determine how much surgery is required.
- Applicability: Surgery is often most effective for early-stage lung cancer when the tumour is localised.
- Types:
- Lobectomy: Removal of the entire lobe of the lung.
- Segmentectomy: Removal of the infected portion of the lung.
- Wedge resection: Removal of a small section of the lung containing the tumour.
- Considerations: Surgery may not be suitable for advanced stages or certain health conditions.
Chemotherapy
Chemotherapy involves the use of drugs to kill or slow the growth of cancer cells throughout the body.
- Applicability: Used in various stages of lung cancer, often in combination with other treatments.
- Administration: Chemotherapy can be given orally or through intravenous infusion.
- Considerations: While effective, chemotherapy can have side effects, including nausea, fatigue, hair loss, and an increased susceptibility to infections.
Radiation Therapy
Radiation therapy as the name suggests uses high doses of electromagnetic waves to target and destroy developing cancer cells.
- Applicability: Can be used as a standalone treatment or in conjunction with surgery or chemotherapy.
- Types:
- External Beam Radiation: Radiation is directed at the cancer from outside the body.
- Internal Radiation (Brachytherapy): Radioactive material is placed directly into or near the tumour.
- Considerations: Side effects may include fatigue, skin changes, and irritation of the oesophagus.
Immunotherapy:
Immunotherapy helps revamp the body’s immune system to protect, recognize and attack cancer cells.
- Applicability: Particularly effective for certain types of non-small cell lung cancer (NSCLC) that express specific markers.
- Types:
- Checkpoint Inhibitors: Block proteins that prevent immune cells from attacking cancer cells.
- CAR T-cell Therapy: Genetically modifies a patient’s T cells to target cancer cells.
- Considerations: Immunotherapy can lead to long-lasting responses and has shown promising results.
Targeted Therapies:
Targeted therapies focus primarily on particular molecules involved in cancer growth.
- Applicability: Primarily used for advanced-stage NSCLC with specific genetic mutations.
- Types:
- EGFR Inhibitors: Target mutations in the epidermal growth factor receptor.
- ALK Inhibitors: Target mutations in the anaplastic lymphoma kinase gene.
- Considerations: Targeted therapies often have fewer side effects compared to traditional chemotherapy.
Clinical Trials
Clinical trials involve testing new treatments or combinations of existing treatments to evaluate their effectiveness.
- Applicability: Patients may consider clinical trials, especially if standard treatments are not yielding desired results.
- Considerations: Participation in clinical trials can provide access to cutting-edge treatments, but potential risks and benefits should be carefully weighed.
Patients must work closely with their healthcare team to determine the most appropriate treatment plan based on their specific diagnosis and circumstances. Additionally, ongoing advancements in research and personalised medicine continue to shape the landscape of lung cancer treatment, offering new hope for improved outcomes.
Prevention and Early Detection
While certain risk factors, such as genetics, cannot be modified, adopting a proactive approach can significantly reduce the likelihood of developing lung cancer. Key prevention strategies include smoking cessation, minimising exposure to environmental carcinogens, and routine health check-ups.
Sum Up
Lung cancer remains a formidable health challenge, but advancements in research and medical technologies provide hope for improved outcomes. Increased awareness, early detection, and lifestyle modifications can collectively contribute to a reduction in the incidence and impact of this disease. By unravelling the mysteries surrounding lung cancer, we empower ourselves to confront it head-on, fostering a future where its shadows no longer loom so ominously.
